The impact on glycemic control through progressive resistance training with bioDensityTM in Chinese elderly patients with type 2 diabetes: The PReTTy2 (Progressive Resistance Training in Type 2 Diabetes) Trial.

AIMS: To evaluate the effects of a novel, low-volume, high-intensity Progressive Resistance Training (PRT) technique on blood glucose control in elderly Chinese patients with Type 2 Diabetes. MATERIALS AND METHODS: The PReTTy2 trial enrolled 300 male and female patients with Type 2 Diabetes in a randomized resistance training program with the bioDensity™ technique. 100 were control patients with no training intervention and 200 had resistance training. Anthropometry, biochemical parameters, HbA1c and fasting plasma glucose (FPG) were measured at baseline, 3-month and 6-month intervals. RESULTS: 265 patients completed the study with no adverse events. There were no statistically significant differences in HbA1c for all patients, control and PRT groups, at baseline (p = 0.60), 3 months (p = 0.42) and 6-months (p = 0.45). Subgroup analysis with baseline HbA1c > 7.5% (58 mmol/mol), showed statistically significant differences in HbA1c and FPG between groups at 6 months (p < 0.05). All PRT group patients had statistically significant differences from baseline at 6 months for HDL (1.25 + 0.32 vs. 1.17 + 0.26 mmol/L, p < 0.001), LDL (3.23 ±â€¯0.89 vs. 2.93 ±â€¯0.80 mmol/L, p < 0.001) and total cholesterol (4.97 ±â€¯1.22 vs. 4.58 ±â€¯1.03 mmol/L, p < 0.001). CONCLUSIONS: PRT improves glycemic indices in elderly patients with Type 2 Diabetes with poor glucose control as an adjunct to diet and medication. Progressive Resistance Training with bioDensity™ is feasible, safe and effective in elderly patients with Type 2 Diabetes.

Practice guidelines for the implementation of a quality program in thromboprophylaxis and treatment management in patients with venous thromboembolic disease.

BACKGROUND: Venous thromboembolic disease is a major cause of morbidity and hospital mortality worldwide. Although exact figures are unknown in Mexico, achieving uniformity of criteria among the specialties involved in the prophylaxis and treatment will offer a clearer picture and contribute to a more rational and interdisciplinary approach in order to improve the quality of care for patients and increase the level of awareness of this entity. DISCUSSION: For the preparation of this document, a total of 11 medical specialists from Mexico City and the interior of the country met along with a highly experienced professional from Chicago, IL, USA with wide experience in the field and knowledge of methodology for the development of a management algorithm for prophylaxis in at-risk patients of venous thromboembolic disease. The expert group met in plenary working sessions, managed uniform criteria and reached consensus agreement by issuing a series of useful recommendations for the care of patients with venous thromboembolism in Mexican hospitals. CONCLUSIONS: In Mexico there is the need to develop and disseminate guidelines on thromboprophylaxis and treatment of venous thromboembolic disease because of the wide disparity of views or simple misinformation, leading to diagnostic and treatment behaviors unique to each institution.

Admission and discharge guidelines for the pediatric patient requiring intermediate care.

During the past three decades, the specialty of pediatric critical care medicine has grown rapidly, leading to a number of pediatric intensive care units being opened across the country. Many patients who are admitted to the hospital require a higher level of care than the routine inpatient general pediatric care, yet not to the degree of intensity as pediatric critical care; therefore, an intermediate care level has been developed in institutions providing multiple disciplinary subspecialty pediatric care. These patients may require frequent monitoring of vital signs and nursing interventions but usually do not require invasive monitoring. The admission of the pediatric intermediate care patient is guided by physiologic parameters depending on the respective organ system involved relative to the institution's resources and capacity in caring for a patient in a general care environment. This report provides admission and discharge guidelines for intermediate pediatric care. Intermediate care promotes greater flexibility in patient triage and provides a cost-effective alternative to admission to a pediatric intensive care unit. This level of care may enhance the efficiency of care and improve the healthcare affordability for patients receiving intermediate care.

Admission and discharge guidelines for the pediatric patient requiring intermediate care.

During the past 3 decades, the specialty of pediatric critical care medicine has grown rapidly, leading to a number of pediatric intensive care units opening across the country. Many patients who are admitted to the hospital require a higher level of care than routine inpatient general pediatric care, yet not to the degree of intensity of pediatric critical care; therefore, an intermediate care level has been developed in institutions providing multidisciplinary subspecialty pediatric care. These patients may require frequent monitoring of vital signs and nursing interventions, but usually they do not require invasive monitoring. The admission of the pediatric intermediate care patient is guided by physiologic parameters depending on the respective organ system involved relative to an institution's resources and capacity to care for a patient in a general care environment. This report provides admission and discharge guidelines for intermediate pediatric care. Intermediate care promotes greater flexibility in patient triage and provides a cost-effective alternative to admission to a pediatric intensive care unit. This level of care may enhance the efficiency of care and make health care more affordable for patients receiving intermediate care.

The state of pediatric interfacility transport: consensus of the second National Pediatric and Neonatal Interfacility Transport Medicine Leadership Conference.

Interfacility transport of pediatric and neonatal patients for advanced or specialty medical care is an integral part of our medical delivery system. Assessment of current services and planning for the future are imperative. As part of this process, the American Academy of Pediatrics and the Section on Transport Medicine held the second National Pediatric and Neonatal Transport Leadership Conference in Chicago in June 2000. Ninety-nine total participants, representing 25 states and 5 international locations, debated and discussed issues relevant to the developing specialty of pediatric transport medicine. These topics included: 1) the role of the medical director, 2) benchmarking of neonatal and pediatric transport programs, 3) clinical research, 4) accreditation, 5) team configuration, 6) economics of transport medicine in health care delivery, 7) justification of transport teams in institutions, and 8) international transport/extracurricular transport opportunities. Insights and conclusions from this meeting of transport leaders are presented in the consensus statement.